Medicare Supplement Plans in Florida

With the upcoming changes to Medigap health plans for 2023, many residents of the Sunshine State are wondering how to go about identifying the best Medicare Supplement plans in Florida. Original Medicare consists of Medicare Parts A and B. These two Medicare plans together cover most inpatient and outpatient care; however, these plans do have premiums, copays, coinsurance, and limitations of coverage, all of which are out-of-pocket costs. This is one reason many Floridians choose to purchase Medicare Supplement Plans.

Best Medicare Supplement Plans in Florida

Around 2.5 million residents of Florida are enrolled in Medicare, and among these, 32% have purchased a Medicare Supplement plan; presumably, most of the rest have Advantage plans. Plan F, which is being replaced by Plan G in 2020, was overwhelmingly the most popular plan, chosen by around 52% of those who purchased a Medigap plan.

Medicare Supplement Plan F: Best Full Coverage

Medicare Supplement Plan F in Florida is a popular and robust Medicare Supplemental plan available.

These are some of the highlights of coverage that you can enjoy helping with medical expenses on top of what the federal Medicare program covers:

• Medicare Part A deductible and Medicare Part B deductible
• Medicare Part A hospital and coinsurance costs
• Medicare Part B deductible, coinsurance, and copayments
• Medicare Part B excess charges
• Medicare Part B coinsurance for preventative care
• First, 3 pints of blood per year when needed for a medical procedure
• Foreign travel emergency medical expenses
• Co-insurance for skilled nursing facility care

Medicare Supplement Plan G: Best Comprehensive Coverage

Medigap Plan G in Florida is quickly becoming most popular among new buyers. Same benefits as Plan F, however, it does not pay for the Medicare Part B Deductible.

Medicare Supplement Plan N: Best Value

Medigap Plan N in Florida is popular as a lower-cost alternative. Offers great coverage with a few compromises that reduce monthly premiums. This is a more comprehensive plan than options like Medigap Plan A, but it’s more affordable than Medigap Plan F and Plan G.

An estimated 21 million people call the Sunshine State home, making it the third-most populous state in the US. It has a large senior population, composing around 23% of the total population. The four largest counties by population in the state are:

• Miami-Dade
• Broward
• Palm Beach
• Hillsborough

Medigap Plan C, which is also being replaced in 2020, came in a distant second in popularity, and Plans K, L, and M were the least popular; Plan M, in particular, was disliked with only 132 people in the entire state selecting it. The unpopularity of these three plans is probably due to the fact that they only provide partial coverage of many of the benefits the other plans provide full coverage for.

What Do Medicare Supplement Plans in Florida Cover?

Medigap policies only cover “gaps” in Medicare coverage; they do not cover services that Medicare does not cover, such as:

• Outpatient prescription drugs
• Dental work and exams
• Vision care, including checkups and eyeglasses
• Hearing checkups and hearing aids
• Life insurance

If a beneficiary desires prescription drug coverage, a Medicare Part D prescription drug plan can be purchased in addition to Medicare Parts A, B, and a Medigap policy. If a beneficiary desires dental and/or vision coverage, some Medicare Advantage plans provide a package policy that covers everything, or the beneficiary can stick with original Medicare and buy private policies from an insurance company that covers these benefits separately. Note that one disadvantage of Advantage vs Original Medicare is that Medicare is accepted nationwide while many Advantage systems are governed by an HMO and require beneficiaries to only use “in-network” health providers.

In order to identify the best Medicare Supplement plans in Florida, in addition to reading this article, it is a good idea to talk to an insurance expert. What plan is best for each individual varies dramatically by the health condition, goals, and financial resources of each person. In addition, some individuals would be better off with Medicare Advantage rather than Medigap.

There are a number of Medigap Supplement plans available in the Sunshine State. Although these plans are sold through private insurance companies, they are standardized by Medicare and offer the same benefits regardless of the insurance company selling them, namely Plan G from Aetna is the same as Plan G from Blue Cross Blue Shield.

It should be noted that starting in 2020, no Medigap health plans will pay for the Part B deductible for people newly enrolling in Medicare, and thus Plans C and F will not be available and are being replaced with Plans G and N. Individuals who enrolled in Medicare prior to 2020 and have a Plan C or F, including a high-deductible plan F, will be able to keep their plans in the future.

All Medigap plans cover:

• Part A coinsurance
• Additional hospital costs (up to an extra 365 days) after Medicare benefits for hospitalization are used up
• Part B coinsurance or copayments (Plans K and L only cover part of these costs)
• Part A hospice care coinsurance or copayment (Plans K and L only cover part of these costs)
• Skilled nursing facility coinsurance (Plans K and L only cover part of these costs)
• The first three pints of blood (Plans K and L only cover part of these costs)

In addition, some plans cover part or all of the Part A deductible, Plans F and G cover Part B excess charges, and some plans partially cover foreign travel medical costs. Plans K and L have an out-of-pocket costs limit but none of the other plans do.

Skilled care and assistance

Many people may look at Plans K and L and think their low premiums are attractive, but the fact that they only cover a certain percentage of some Medicare “gaps” can cause serious financial problems. For example, many elderly people end up needing to stay for a period of time in a skilled nursing facility. Coinsurance costs at a skilled nursing facility can rapidly add up, and someone with a Plan K that only covers 50% of these costs can end up destitute.

Some Medicare beneficiaries may be wondering why none of the Medigap policies covers home health assistance services. That is because home health, under certain conditions, is fully covered by Medicare benefits and is not considered to be a “gap” in coverage.

Excess charges

Part B excess charges refer to a doctor charging Medicare for more than Medicare usually pays for a particular service. In some states, including in Florida, doctors can reject what is called “assignment” and may be allowed to charge 15% over the usual Medicare fee, which the patient is required to pay to the doctor. It is wise to confirm your doctor accepted the Medicare assignment before a visit. If you wish to continue seeing your usual doctor who charges excess charges, it is probably a good idea to purchase one of the health insurance Medigap health plans that cover excess Medicare Part B charges.

Comparing Medicare Supplement Plans in Florida

Florida offers the ten standardized Medigap plans that are provided in practically all states. In addition, they offer a high-deductible option for Plans F and G where full benefits don’t apply until the recipient has paid a certain amount out of pocket per year. These plans may be a very cost-effective choice for individuals who are generally healthy and rarely require anything other than routine health care such as Medicare preventive care because their monthly premiums are much lower than the monthly premiums of the standard F and G plans.

However, choosing a high-deductible option can turn into a disaster if the recipient suffers unexpected healthcare needs and ends up paying the full yearly deductible on a regular basis; this can easily cost more in the end than paying for the higher monthly premiums for the regular plans.

When Can You Enroll in a Florida Medigap Plan

The best time to enroll in a Medigap plan is during your initial Medicare enrollment period, which begins on your 65th birthday and extends for six months. During this period, if you are enrolled in Original Medicare, you can purchase any Medigap plan Florida offers regardless of your health status. After this period, insurance companies may require you to undergo a physical or submit health records, and they can refuse to sell your preferred plan to you.

The monthly premium for your Medicare Supplement insurance depends on your general characteristics and your health status. In Florida, most insurance companies use a method called issue-age rated where the premium is set by your age when you first buy it. The premium may increase over time due to inflation but it doesn’t increase as you get older nor does it change if you develop new health conditions.

There is a 30-day return period for Medigap policies; if you purchase one and find out you don’t like it after reading all the fine print, you can return it with no questions asked and all fees returned within 30 days of initial enrollment.

Once you have purchased a Medigap plan, as long as you pay your premium the insurance company cannot cancel your policy. Thus, even if you develop serious health problems you are guaranteed re-enrollment in your preferred policy.

The general Medicare open enrollment period is from October 15 through December 7. In Florida, this period doesn’t apply to Medigap plans. During this period, in Florida, you can:

• Switchback and forth between original Medicare and a Medicare Advantage plan
• Switch between two different Medicare Advantage plans
• Change your Medicare Part D (drug coverage) plan
• Buy a new Part D prescription drug plan if you didn’t previously

Learn More About Medicare Supplement Plans in Florida

SHINE is a free service offered in Florida to assist seniors with Medicare. Trained volunteers can provide information, advice, and assistance with questions about healthcare and Medicare.

Additional Resources: https://www.mybenefits.myflorida.com/health/health_insurance_plans/medicare